Our clinic has been in existence for almost a quarter of a century (established
1993)
We maintain IVF success rates on par with the best clinics in the world.
TECHNIQUE - CLINICAL PREGNANCY RATE (Rounded off as averages)
|
TECHNIQUE
|
CLINICAL PREGNANCY RATE (%)
|
|
Intrauterine Insemination (IUI)
|
15-20%
|
|
In vitro fertilization (IVF)
|
40-50%
|
|
Intracytoplasmic sperm injection (ICSI)
|
40-50%
|
|
Egg (oocyte) donation (OD)
|
60%
|
|
Embryo donation (ED)
|
60%
|
Recent Advances and Trends
We have several approaches for patients with failed IVF. After a detailed evaluation of the probable cause of failure we try and make several changes. This includes change of protocol for ovarian stimulation (choice of long agonist vs short antagonist), change of hormones (Pure FSH vs FSH + LH vs HP-HMG vs HMG alone), change of type of transfer (fresh or frozen), choice of preparation of endometrium (with hormonal pills and gels or in a natural cycle), change of stage of embryo (Day 2 vs 3 vs Blastocyst) and change of medication post embryo transfer. The approach is individualized and tailor made for maximising the success rates.
The clinic strikes a delicate and scientific balance between conducting fresh and frozen embryo transfers on an individualized basis. Also, we have found similar pregnancy rates with day 2,3 or 5 (blastocyst) transfers so the decisions for day of transfer are also individualised taking into consideration past cycles, number of viable and top quality embryos and endometrial status.
IVF add-ons such as Preimplantation genetic testing (PGT), Endometrial receptivity assay (ERA), laser hatching, embryo glue, etc are used judiciously and only as and when required. For example, PGT is used if there is a history of recurrent miscarriages of genetic origin, presence of some hereditary condition / disease in one or both partners, advanced maternal age, history of an abnormal child in the couple or their siblings, etc. Recent studies have shown that PGT does not improve success rates in patients with unexplained recurrent IVF failures. So also, ERA has a limitation that it’s prediction of the window of implantation is valid only for the cycle in which the test has been performed and might not be predictive of the window of implantation in the subsequent cycle. Laser hatching is only done if the oocytes show a thick outer coat (zona pellucida).
Currently, the clinic performs "FREEZE ALL" cycles for some patients. This means that we
stimulate the ovaries, retrieve the eggs, fertilize them and freeze all the embryos.
Embryo transfer would NOT be done in the stimulation cycle (NO FRESH EMBRYO TRANSFER).
In the subsequent month, the uterus is primed with appropriate medication to improve
its receptivity and frozen embryos are transferred once this is achieved.
Frozen embryo transfer is particularly advantageous in the following situations:
-
Retrieval of less than optimal
number of eggs and embryos (less than 3 embryos of grade 1).
-
Patients with low AMH and poor
responders (pooling of embryos).
-
History of previous miscarriage
/ biochemical pregnancy
-
History of previous ectopic pregnancy.
-
Retrieval of more than 15 eggs
(to avoid ovarian hyperstimulation).
-
Endometrium (uterus lining) thin
or < 7 mm in thickness.
-
History of previous IVF failures
with fresh transfers.
-
Abnormal hormone levels (elevated progesterone) in the stimulation cycle.
-
Patients with polycystic ovaries.
-
Patients with endometriosis.
IVF success rates have been quite steady for more than two decades now. With “Fresh”
embryo transfer (transfer in the same cycle as the egg retrieval) pregnancy rates
were in the range of @ 40-45% and after correcting for pregnancy losses and miscarriages,
the net take home baby was in the range of 37-40%.
How did we do?
For the past decade, our success rates have been consistent at 40-50% for self-egg IVF and ICSI cycles and around 50-60% for egg or embryo donation cycles